CareFirst BlueCross BlueShield Advantage DualPrime is committed to providing the best possible health care to all its members. The CareFirst BlueCross BlueShield Advantage DualPrime Quality Improvement Program monitors the quality of care and services provided to its members. The Quality Improvement Program is integrated throughout the health plan and is governed by a committee structure composed of doctors, pharmacists, nurses, and quality program analysts. These committees regularly measure the health plan’s performance and recommend improvements for all health plan functions.

CareFirst BlueCross BlueShield Advantage DualPrime continuously evaluates its Quality Improvement Program using nationally recognized measures such as The Healthcare Effectiveness Data and Information Set (HEDIS), the Consumer Assessment of Healthcare Providers & Systems (CAHPS), the Centers for Medicare and Medicaid Services (CMS) STARS Measures, and the Health Outcomes Surveys (HOS). These measures help CareFirst BlueCross BlueShield Advantage DualPrime determine if its members are receiving the care they need and are satisfied with that care. Certain measures also allow CareFirst BlueCross BlueShield Advantage DualPrime to assess the overall health status of its members to ensure all members remain healthy and well.

Using the results of these measures CareFirst BlueCross BlueShield Advantage DualPrime annually sets goals and objectives for its Quality Improvement Program. At the end of every year CareFirst BlueCross BlueShield Advantage DualPrime reviews its Quality Improvement Program for both achievements as well as opportunities for improvement identified from the previous year.

Satisfaction Survey
CareFirst BlueCross BlueShield Advantage DualPrime analyzes feedback from members who respond to the annual Consumer Assessment of Healthcare Providers and Systems (CAHPS) member survey. This survey is organized by the Centers for Medicare and Medicaid Services (CMS) every year. We use your feedback to improve our customer service and your overall healthcare experience. CareFirst BlueCross BlueShield Advantage DualPrime also conducts satisfaction surveys of its own throughout the year. Below please see our 2023 scores for the CAHPS survey of Medicare members. The ratings indicate the percentage of our members who responded positively to each question.

2023 CAHPS SCORE

 In 2023, we improved our ratings in 7 of the 9 CAHPS satisfaction survey. CareFirst BlueCross BlueShield Advantage DualPrime is dedicated to continuing to improve these ratings to provide you with the best care possible.

Health Education 
The goal of providing health education is to empower members with information on how to take control of their health. The information we gather in our Quality Improvement Program assists us to understand the members we serve and allows CareFirst BlueCross BlueShield Advantage DualPrime to take action to provide up-to-date, easy-to-understand health education to its members. Examples of Health Education services provided by CareFirst BlueCross BlueShield Advantage DualPrime are mailings, newsletters, our website, disease management and case management services.

Cultural Competency Program
CareFirst BlueCross BlueShield Advantage DualPrime strives to build health care systems that consider members’ ethnic backgrounds, age, gender, lifestyles, language, disabilities, reading levels, religion, and the communities in which they live. CareFirst BlueCross BlueShield Advantage DualPrime believes that members experience better health outcomes and results when care is delivered in their own language and their cultural background is taken into account. In addition to providing interpreter services free of charge and building a diverse network of participating providers, CareFirst BlueCross BlueShield Advantage DualPrime provides annual training to its employees to support  them in their ability to provide culturally competent care. Cultural competency training is also available to all CareFirst BlueCross BlueShield Advantage DualPrime network providers. 

Patient Safety
Providing safe medical care and preventing complications is a priority. The Quality Improvement Program includes several methods to ensure safe and effective medical care is provided to its members. First, CareFirst BlueCross BlueShield Advantage DualPrime contracts with well-qualified providers that meet high standards. Other measures to promote safety and reduce complications include reviewing certain high risk medical procedures or medications to confirm these are necessary, tracking health outcomes and investigating every quality-of-care complaint received from its members.

For more information on CareFirst BlueCross BlueShield Advantage DualPrime’s Quality Improvement Program please contact Member Services 410-779-9932 or toll-free at 1-844-386-6762 (TTY: 711), 8 AM to 8 PM EST, 7 days a week from October 1 – March 31; and 8 AM to 8 PM EST, Monday through Friday from April 1 – September 30 and ask to speak with the Quality Improvement Department about our Quality Improvement Program or email QualityMD@CareFirst.com.

Updated: October 2023